Neck Pain

- EVERYBOBY GETS NECK PAIN -

We will all experience neck pain at some time in our lives. About 15% of us will have neck pain this year. More than 5% of us have neck pain right now. Neck pain is a very common cause of disability in the general population.

Because it’s so common, we have a lot of information about it...

HOW LONG DOES NECK PAIN LAST?

On average, people suffer with neck pain for a period of 14-21 days. Some people are sore for a couple of days, some people are sore for a couple of months or longer, but the average is 2 to 3 weeks.

After the initial episode, 70% of people have a recurrence of neck pain within the following 12 months. It is very common to have a recurrent pattern of your neck "playing-up" for a week or two, once or twice a year.The initial period of neck pain we call “acute”. If the pain continues for more than 3 months, we call it “chronic”. If the pain recurs at regular intervals over a number of years, each episode can be called “acute on chronic”.

WHAT’S WRONG WITH MY NECK?

If we MRI every person with neck pain, to try and get a nice clear picture of what’s going on, in the vast majority of cases we can’t see anything serious.

In less than 1% of people with neck pain we see something very serious like a fracture, infection, or a tumour. Another 4% of neck pain is caused by a structural injury that may need investigating (for example a disc injury, such as a herniation or extrusion).

However, in 95% of neck pain we can’t see any pathology that we can be sure is causing the pain. We can tell that you’re in pain, and we may see a few ugly things on imaging, but it’s not possible to identify the specific anatomy that’s causing the problem. Is it the disk / muscle / joints / ligaments / nerves / bone?... We can’t always tell you exactly. So the majority of neck pain gets called “non-specific” neck pain, or “mechanical” neck pain, because we don't believe anatomical structural damage is the problem. Neck pain is less a case of something being damaged or injured (like an ankle sprain), but more a pain problem. There's nothing broken, or "out". It's not a structural injury. It's a pain problem.

This doesn't make it any less serious.

CAUSES OF NECK PAIN

There are some common causes of neck pain. The most common is sustained sitting or standing with a chin-forward posture. Our necks are much happier when we are moving around. Motion is lotion. When we get stuck staying still in the one position our joints can start to get sore.From an evolutionary point of view we’ve had 100,000 generations of being hunter-gatherers, moving around, doing different things all day. We’ve only had 10 generations of industry, where we do the one thing all day, commonly including too much sitting. Our bodies just aren't used to sitting for long periods of time.

There has been some media recently suggesting "sitting is the new smoking". I think we will see a changes in workplaces over the next few years to limit people's sitting time. Research suggests we need to get up and move around for a minute every 20 minutes. I think we will see more stand-up desks, stand-up meetings, "walk-around" meetings, and enforced limits on sitting time.

PROGNOSIS FOR NECK PAIN

The prognosis for neck pain is good. If we study how people feel 6 weeks, 6 months, and 1 year after the start of their neck pain, the majority have recovered, no matter whether they seek treatment or not. It is generally regarded that non-specific or mechanical neck pain is self-limiting. Even if you don't do anything about it, it will get better by itself. Good news.

You can think of it a bit like the common cold - everyone gets it once or twice a year, you're crook for a couple of weeks, & it gets better by itself.

TREATMENTS FOR NECK PAIN

There are a range of treatment options, from conservative treatments like heat and massage, to more aggressive medical treatments like injections and surgery. Again, long-term (12 month) prognosis is good, regardless of the treatment given.In the short-term, based on the best available scientific evidence, The National Health & Medical Research Council recommend:

Staying active

Regular paracetamol (3-4g day)

Heat

Massage

As a Physio treatment, I like to find a stretch you can do that gives you relief. Then, the more you do it, the better you feel, & that gives you some control, so you know what to do when your neck is "playing-up". I like “hands-on” treatments like massage. I like to use taping techniques to support your muscles while they are sore.